BCGite après une revaccination accidentelle par le BCG

Abstract

We report a cutaneous ulceration which occurred following a BCG revaccination. A 17 year old man, without previous history, presented a large and slow progressive ulceration of the left deltoid area following a fortuitous BCG revaccination. He did not complain of any other symptom. The swab culture from the exudate isolated Mycobacterium bovis whereas the direct analysis by Ziehl staining was negative. The ulceration healed in four months with local and systemic treatment with isoniazid. BCG vaccination side effects are largely described and can be either nonspecific, like with all vaccinations, or specific and due to the infection with Mycobacterium bovis. It can behave like an infectious agent or an immunogenic agent. The BCG revaccination complications are much less known because there are only few publications in the literature. In our case, the mechanism may have been infectious or imply immune reaction with Arthus'type-phenomenon and/or a type IV hypersensitivity. Adverse reactions due to revaccination are rarely described should became less frequent when the BCG revaccination is abandoned following the decision of French regulatory authorities. Nevertheless, such complications can occur by accident, as the case in our patient.